Provider Demographics
NPI:1447504618
Name:WILLIAMS, CARLISA KLUGH (LPC)
Entity type:Individual
Prefix:MRS
First Name:CARLISA
Middle Name:KLUGH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6689 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3404
Mailing Address - Country:US
Mailing Address - Phone:248-302-8111
Mailing Address - Fax:248-242-6749
Practice Address - Street 1:2818 TREYBURN LN
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48324-4106
Practice Address - Country:US
Practice Address - Phone:248-302-8111
Practice Address - Fax:248-242-6749
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006989101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor